Lack of desire is the most frequently experienced problem presented by clients requesting sex therapy at Seattle Institute. The problem manifests as a disinterest in or avoidance of sex and, in many cases, is reflected as a discrepancy in two peoples’ desired frequency of sexual contact.
Lack of sexual desire is a problem that presents both partners in a relationship with a confusing dilemma. Couples often question the level of commitment and caring for one another when one or both lack sexual interest. A cycle often develops resulting in their undergoing increasing levels of stress in daily interactions which negatively impact problem-solving skills and communication patterns. While most (certainly some) couples may be reevaluating their commitment with a corresponding change in sexual desire, there is a broader range of factors that impact sexual interest.
Initial therapeutic assessment takes into account physiological problems that may be contributing to a decrease in sexual functioning. Medical evaluations often focus on assessing hormone levels, thyroid function, use of medications such as anti-hypertensive medications, vaginal infections, or any other illnesses or conditions that may affect sexuality. In addition, the use of alcohol and drugs must be evaluated since research has shown that excessive use of chemicals can drastically decrease sexual interest either while using or during recovery.
Once all physiological components have been ruled out, assessments focus on the interactions of the couple, their communication patterns, sexual expectations, stress levels, and the amount of time set aside for emotional and sexual contact. The lack of sexual desire is a frustrating problem for many couples irrespective of the causes. Entrenched patterns of responding often result in the inability to change dysfunctional interactions even though partners may spend many years attempting to understand and resolve their distress.
Treatment begins with structured and individualized touching exercises that the couple does at home between therapy sessions. They learn to be together physically and emotionally without the pressure and demand to feel or be sexual. Verbal and nonverbal communication is enhanced as attitudes, behaviors, and relationship dynamics are explored and modified. Each person learns that they are in control of their sexuality and can choose if and when to turn on or turn off their feelings.